美国一名肺移植受者中一株对伏立康唑耐药、对泊沙康唑敏感的烟曲霉分离株的分子特征分析
Molecular Characterization of a Voriconazole-Resistant, Posaconazole-Susceptible Aspergillus fumigatus Isolate in a Lung Transplant Recipient in the United States.
作者信息
Vazquez Jose A, Manavathu Elias K
机构信息
Section of Infectious Diseases, Department of Medicine, Georgia Regents University, Augusta, Georgia, USA.
Section of Infectious Diseases, Department of Medicine, Georgia Regents University, Augusta, Georgia, USA
出版信息
Antimicrob Agents Chemother. 2015 Nov 16;60(2):1129-33. doi: 10.1128/AAC.01130-15. Print 2016 Feb.
Abstract
Molecular characterization of cyp51A from the azole-resistant Aspergillus fumigatus isolate 50593 from a lung transplant patient showed Y121F/T289A changes coupled with a 46-bp tandem repeat (TR46) on the promoter, whereas cyp51A from the pretherapy isolate, A. fumigatus 47381, showed no changes. This is the first reported case of A. fumigatus azole resistance due to Y121F/T289A/TR46 in the United States, suggesting that multiple mutational alterations of cyp51A resulting in high-level azole resistance could occur during prolonged antifungal therapy.
摘要
对一名肺移植患者的耐唑类烟曲霉分离株50593的cyp51A进行分子特征分析，结果显示其发生了Y121F/T289A变化，同时启动子上有一个46 bp的串联重复序列（TR46），而治疗前分离株烟曲霉47381的cyp51A未出现变化。这是美国首次报道因Y121F/T289A/TR46导致烟曲霉对唑类耐药的病例，表明在长期抗真菌治疗期间，cyp51A可能发生多种导致高水平唑类耐药的突变改变。
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